Form 8855 - Election To Treat A Qualified Revocable Trust As Part Of An Estate

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8855
Election To Treat a Qualified Revocable
Form
Trust as Part of an Estate
(Rev. January 2009)
OMB No. 1545-1881
Department of the Treasury
Internal Revenue Service
Part I
Estate (or Filing Trust) Information
Name of estate (or the filing trust, if applicable (see instructions))
Employer identification number
(see instructions)
Name of executor (or the filing trustee, if applicable)
Type of entity prior to the election:
Domestic
Foreign
estate
estate
Number, street, and room or suite no. (or P.O. box number if mail is not delivered to street address)
Domestic
Foreign
trust
trust
Date of executor’s appointment
City or town, state, and ZIP code (if a foreign address, see instructions)
Under penalties of perjury, I, as executor (or filing trustee):
Confirm that under applicable local law or the governing document, I have the authority to make this election for the estate (if
executor) or trust (if filing trustee) and to agree to the conditions of the election;
Elect the treatment provided under section 645 for the above-named estate (or filing trust, if applicable);
Confirm that an agreement has been reached with the trustees of each qualified revocable trust (QRT) joining in the election to
allocate the tax burden of the combined electing trusts and related estate, if any, for each tax year during the election period in a
manner that reasonably reflects each entity’s tax obligation;
Agree to ensure that the related estate’s (or filing trust’s, if applicable) share of the tax obligations of the combined electing trust(s)
and related estate, if any, is timely paid to the United States Treasury;
Agree to accept responsibility for filing a complete, accurate, and timely income tax return, when required by law, for the combined
electing trust(s) and related estate, if any, for each tax year during the election period;
(If I am the filing trustee) confirm that if there is more than one QRT making this election, that I have been appointed by the trustees
of each QRT making this election to be the filing trustee and I agree to accept the responsibility of filing the appropriate income tax
return for the combined electing trust(s) for each tax year during the election period and all other responsibilities of the filing trustee;
(If I am the filing trustee) represent that no executor has been appointed for a related estate and to the best of my knowledge and
belief, one will not be appointed;
(If I am the filing trustee) agree that, if an executor is appointed for the related estate after this Form 8855 is filed, that I will complete
and file an amended Form 8855 if the late appointed executor agrees to the election, and I agree to cooperate with the executor in
filing any amended returns required to be filed as a result of the executor’s appointment; and
Confirm to the best of my knowledge and belief, that all information contained in this election and any accompanying statements or
schedules is true, correct, and complete.
Signature of executor (or filing trustee)
Date
Part II
Decedent Information
Name of decedent
SSN of the decedent
Date of death
8855
For Paperwork Reduction Act Notice, see page 4.
Cat. No. 24542R
Form
(1-2009)

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